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Assessment Techniques History Demographic data Family history and genetic risk Personal history Diet history – Anorexia – Dyspepsia 1/09

4
Current Health Problems Pattern of bowel movements Color and consistency of the feces Occurrence of diarrhea or constipation Effective action taken to relieve diarrhea or constipation Presence of frank blood or tarry stools Presence of abdominal distention or gas 1/09

10
Barium Enema Barium enema enhances radiographic visualization of the large intestine. Only clear liquids are given 12 to 24 hr before the test; NPO the night before; bowel cleansing is done. After the test, expel the barium: drink plenty of fluids; stool is chalky white for 24 to 72 hr. 1/09

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Percutaneous Transhepatic Cholangiography X-ray study of the biliary duct system Laxative before the procedure NPO for 12 hr before test Coagulation tests, intravenous infusion Bedrest for several hours after procedure Assessment of vital signs Client positioned on right side with a firm pillow or sandbag placed against the lower ribs and abdomen (Continued) 1/09

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Esophagogastroduodenoscopy Visual examination of the esophagus, stomach, and duodenum NPO for 6 to 8 hr before the procedure Conscious sedation After the test, assessment of vital signs every 30 min NPO until gag reflex returns Throat discomfort possible for several days 1/09

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Gastroesophageal Reflux Disease AKA GERD Occurs as a result of the backward flow (reflux) of gastrointestinal contents into the esophagus Reflux esophagitis characterized by acute symptoms of inflammation Esophageal reflux occurs when gastric volume or intra-abdominal pressure is elevated, the sphincter tone of the lower esophageal sphincter (LES) is decreased, or it is inappropriately relaxed. 1/09

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Diverticula A pouchlike herniation through the muscular wall of a tubular organ. May occur in the stomach, SI, or most commonly, the colon. Zenkers diverticulum most common Diet therapy : size and frequency of meals Surgical management Both sexes are equally affected Incidence increases with age Diet high in refined sugars 1/09

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The nurse should explain that a diet for a peptic ulcer will most likely consist of which of the following? 1. Bland foods 2. High protein foods 3. Any foods that are tolerated. 4. Large amounts of milk. 1/09

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Obesity and Health Promotion Health promotion/illness prevention – Teach the potential consequences and complications. – Teach the importance of eating a healthy diet. – Teach that foods eaten away from home tend to be higher in fat, cholesterol, and salt, and lower in calcium. 1/09

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Obesity and Health Promotion – Reinforce need for regular moderate activity for at least 30 min per day. – Educate regarding diet and activity for children and adolescents, and continuing throughout adulthood. 1/09